直接皮层电刺激在定位前庭功能皮层中的应用  

Mapping the vestibular functional cortex based on direct electrical stimulation

作　　者：李嫣然 吴迪[1] 徐翠萍[2] 王雪原[2] 亓蕾 杜佳琳 遇涛[2] 任连坤 Li Yanran;Wu Di;Xu Cuiping;Wang Xueyuan;Qi Lei;Du Jialin;Yu Tao;Ren Liankun(Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Beijing Institute of Functional Neurosurgery,Department of Functional Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经内科,北京100053 [2]首都医科大学宣武医院功能神经外科,北京功能神经外科研究所,北京100053

出　　处：《中华神经医学杂志》2021年第5期463-468,共6页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金(82071454)。

摘　　要：目的明确直接皮层电刺激(DES)在定位前庭功能相关皮层中的应用价值及前庭功能皮层区域分布。方法回顾性分析首都医科大学宣武医院功能神经外科自2016年1月1日至2019年12月20日收治的17例已置入立体定向电极(SEEG)的药物难治性癫痫患者资料。根据患者DES功能定位结果,将引起前庭症状的刺激位点在MNI标准空间中进行重建并对其解剖位置进行精准定位,从而在群组中获得精准的前庭功能皮层图。结果引起17例患者前庭症状的DES位点共有33个,其中9个(28%)位于缘上回,6个(18%)位于楔前叶,6个(18%)位于后岛,1个(3%)位于前岛,4个(12%)位于颞上回,2个(6%)位于题中回,4个(12%)位于中央前回,1个(3%)位于扣带回。位于岛叶皮层的电刺激强度最小(平均强度2.43mA),其中6个位于岛后的刺激位点的平均刺激强度为2.17mA。结论本研究采用DES技术进一步证实了人类存在涉及前庭信息处理的特异性皮层区域,该区域集中位于岛叶皮层、颞上回、颞中回、缘上回、楔前叶、中央前回及扣带皮层。Objective To clarify the application value of direct cortical electrical stimulation(DES)in locating vestibular functional cortices and the distribution of vestibular functional cortices.Methods Implantation of stcreo-cicctrocnccphalography(SEEG)electrodes was performed in 17 drug-resistant epilepsy patients in our hospital from January12016 to December 2019.The clinical data of these patients were retrospectively analyzed.DES was performed on these patients and stimulation sites eliciting vestibular symptoms were selected to evaluate accurately anatomic locations of stimulation sites eliciting vestibular symptoms in standard Montreal Neurological Institute(MNI)space,and acquired accurate vestibular functional maps in groups.Results There were 33 stimulation sites eliciting vestibular symptoms,including 9 sites(28%)located in the supramarginal gyrus,6 sites(18%)located in the precuneus,6 sites(18%)located in the posterior insular cortex,1 site(3%)located in the anterior insular cortex,4 sites(12%)located in the superior temporal gyrus,2 sites(6%)located in the middle temporal gyrus,4 sites(12%)located in the precentral gyrus,and 1 site located in cingulate cortex(3%).Stimulation sites eliciting vestibular symptoms induced by lowest intensity located in the insular cortex(average intensity was 2.43 mA).and the average intensity of 6 stimulation sites located in the posterior insular cortex was 2.17 mA.Conclusion The functional cortex associated with vestibular symptoms defined by DES sites including the insular cortex,superior temporal gyrus,middle temporal gyrus,superior marginal gyrus,precuneus,precentral gyrus,and cingulate cortex.

关 键 词：前庭症状 直接皮层电刺激 前庭功能皮层 

分 类 号：R651.1[医药卫生—外科学]